Provider Demographics
NPI:1144608951
Name:CAPECE, JESSE COLIN (LICSW)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:COLIN
Last Name:CAPECE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 JENCKES HILL RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4603
Mailing Address - Country:US
Mailing Address - Phone:401-287-4032
Mailing Address - Fax:
Practice Address - Street 1:1570 WESTMINSTER ST FL 2
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1805
Practice Address - Country:US
Practice Address - Phone:401-287-4032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW022021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical